Provider Demographics
NPI:1053675124
Name:DHUYVETTER, AMANDA (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:DHUYVETTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1653 W CONGRESS PKWY
Mailing Address - Street 2:SUITE 720 PAVILION
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3833
Mailing Address - Country:US
Mailing Address - Phone:312-942-6610
Mailing Address - Fax:312-942-6606
Practice Address - Street 1:1653 W CONGRESS PKWY
Practice Address - Street 2:SUITE 720 PAVILION
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3833
Practice Address - Country:US
Practice Address - Phone:312-942-6610
Practice Address - Fax:312-942-6606
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036138158207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology